摘要
目的 评价胃肠道手术新生儿围术期液体治疗对血糖的影响.方法 择期行胃肠道手术新生儿64例,ASA分级Ⅰ或Ⅱ级,随机分为4组（n=16）,Ⅰ组麻醉前2 h口服清水,术中输注等张的醋酸林格氏液;Ⅱ组麻醉前2 h口服清水,术中输注2%葡萄糖生理盐水溶液;Ⅲ组麻醉前2 h口服10%葡萄糖液5 ml/kg,术中输注等张的醋酸林格氏液;Ⅳ组麻醉前2 h口服10%葡萄糖液5 ml/kg,术中输注2%葡萄糖生理盐水溶液.分别于麻醉诱导前补液开始即刻（T0）、麻醉诱导即刻（T1）、手术开始即刻（T2）、20 min（T3）、40 min（T4）、60 min（T5）、术后2 h（T6）时记录MAP和HR,同时取桡动脉血样测定血糖浓度,并于T0时测定乳酸浓度.结果 各组新生儿MAP和HR组内和组间比较差异无统计学意义（P＞0.05）.与Ⅰ组比较,Ⅱ组和Ⅳ组T4-6时血糖浓度升高（P＜0.05）,Ⅲ组各时点血糖浓度差异无统计学意义（P＞0.05）;Ⅱ组和Ⅳ组各时点血糖浓度差异无统计学意义（P＞0.05）.与Ⅰ组比较,Ⅲ组血乳酸浓度升高（P＜0.05）;与Ⅱ组比较,Ⅳ组血乳酸浓度升高（P＜0.05）.结论 胃肠道手术新生儿术前口服10%葡萄糖液,术中持续输注2%葡萄糖生理盐水溶液有利于维持围术期血糖的稳定.
Objective To investigate the effect of perioperative fluid therapy on blood glucose in the neonates undergoing gastrointestinal operation. Methods Sixty-four ASA Ⅰ or Ⅱ neonates undergoing gastrointestinal operation were randomly divided into 4 groups （ n = 16 each）. Group Ⅰ received water orally 2 h before operation and iv infusion of acetated Ringer＇s solution during operation. Group Ⅱ received water orally 2 h before operation and iv infusion of 2% glucose （in normal saline） during operation. Group Ⅲ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of acetated Ringer＇s solution during operation. Group Ⅳ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of 2 % glucose （in normal saline） during operation. Blood sam ples were collected from radial artery for determination of blood glucose concentrations at the beginning of fluid therapy （T0）, immediately after induction of anesthesia （T1）, at the beginning of operation （T2）, and at 20,40and 60 min （T3-5） and 2 h after operation （ T6 ）. MAP and HR were also recorded simultaneously. The blood lactic acid concentration was determined at T0 . Results There was no significant difference in MAP and HR among the 4 groups. Compared with group Ⅰ , blood glucose concentrations were significantly increased at T4-6 in group Ⅱand Ⅳ, but no significant change was found in blood glucose concentrations at each time point in group Ⅲ. There was no significant difference in blood glucose concentrations between group Ⅱ and Ⅳ. The blood lactic acid concentration was significantly higher in group Ⅲ than in group Ⅰ , and in group Ⅳ than in group Ⅱ . Conclusion Oral 10% glucose 5 ml/kg before operation and iv infusion of 2% glucose （in normal saline） during operation is beneficial for the stabilization of blood glucose levels in neonates undergoing gastrointestinal operation.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2010年第8期966-969,共4页
Chinese Journal of Anesthesiology
关键词
补液疗法
血糖
婴儿
新生
手术期间
Fluid therapy
Blood glucose
Infant, newborn
Intraoperative period
